Parinaud oculoglandular syndrome

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at November 2, 2016
Start › Diseases › Parinaud oculoglandular syndrome

Parinaud oculoglandular syndrome, which is associated with cat-scratch disease and tularemia, is a condition that affects the eyes and is similar to pink eye (conjunctivitis). This syndrome is sometimes accompanied by swollen lymph nodes and flu-like symptoms. Parinaud oculoglandular syndrome is not that same as Parinaud's syndrome, which is a very serious eye condition that is usually associated with a brain tumor.

Contents

Definition & Facts

Over 20,000 people in the United States get Parinaud oculoglandular syndrome each year. It is an infection that causes red, itchy eyes, and is often caused by a cat scratch. It affect both genders equally and might also be contracted from contact with rabbits, ticks or fleas.

In most cases, a cat or kitten picks up the bacteria from fleas and then transfers it to humans through scratches or bites. In general this syndrome is considered a nuisance, but if left untreated it can spread to other organs and become quite serious.

Symptoms & Complaints

The main symptom of this syndrome is the appearance of eyes that are bloodshot, itchy and pink. Usually the patient will have blurred vision in one eye and a slight fever or general illness that includes a headache and nausea. The eyes will tear up excessively and water very frequently.

This might be accompanied by joint pain, muscle pain, and swollen lymph glands in the neck or near the ears. In rare cases, there might be growths or nodules on the underside of an eyelid or on the white portion of the eye (sclera). Rarely, this syndrome can affect other organs like the brain and heart. This usually happens in people with weakened immune systems or in children up to the age of four. 

Causes

Parinaud oculoglandular syndrome is typically caused by a bacterial infection. Francisella tularensis and Bartonella henselae are two types of bacteria that cause this condition. The bacteria might directly enter the eye either from a person rubbing their eyes or simply from the bacteria being in the air.

The main source of this syndrome is from cats, who pick up the bacteria from fleas and then transfer it to their owners. Even cats who are cleaned regularly can carry the bacteria. Kittens in particular can transfer the disease through a scratch or bite. Often this syndrome is contracted from petting a cat and then rubbing the eyes. It is also possible to contract this illness through a cat licking a an open wound on a person. This syndrome is also carried by wild rabbits, squirrels and ticks.

Those with weakened immune systems due to cancer, HIV infection or an organ transplant are more susceptible to Parinaud oculoglandular syndrome. This syndrome is also known to be linked to herpes virus. 

Diagnosis & Tests

The doctor will start off with inquiries into a patient's medical history and family history and a physical examination to assess the patient's symptoms. If the doctor suspects Parinaud oculoglandular syndrome, they will ask about cats and cat scratches.

The doctor will do a vision test, possibly holding up fingers or using an eye chart. The patient's eye movements and ability to follow a moving object will be checked, and the physician will take a look at pupil dilation. The doctor will closely examine the structure of the eye to check for abnormalities and complications.

The physician will order a blood test to check for an infection. They will be looking carefully at the patient's white blood cell count and whether it is outside the normal range. The doctor will also look for antibody levels, which is the most common way to determine if there is an infection present.

In some cases, the doctor will do a biopsy of a lymph node and they might also do a lab culture of the eye fluids. The physician could order an magnetic resonance imaging (MRI) scan to check for more serious causes.  

Treatment & Therapy

This condition will eventually get better on its own and is considered self-limiting. Doctors usually prescribe antibiotics like doxycycline to treat it. In some cases, a patient is given corticosteroids. Erythromycin is another antibiotic that is sometimes used to treat the condition.

Prevention & Prophylaxis

In general, a doctor should be consulted if an eye becomes red, swollen, or itchy for early diagnosis. One of the best ways to prevent Parinaud oculoglandular syndrome is to practice good hygiene. Hands should be washed often.

People with cats need to take care to avoid being scratched, even if the cat is clean and healthy. Cats should be subjected to regular veterinarian visits and given flea and tick protection.

Contact with rabbits, squirrels and ticks can cause tularemia, which is linked to Parinaud oculoglandular syndrome, so they should be avoided as well. In general, a person needs to be very careful if they live somewhere where ticks are presents and should be extra careful if they do gardening or landscaping work. Wearing long-sleeved shirts and long pants in areas with tall grass or in heavily-wooded areas can help prevent bites from ticks. Insect repellent may also be worn to mitigate risk.

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